Tinnitus treatment

• Patients with Tinnitus: Their Perspective on Sound Generators
• A rare neurological odyssey: Gastric adenocarcinoma and leptomeningeal carcinomatosis - A Peruvian case study
• Transverse venous sinus stenting versus cerebrospinal fluid shunting in idiopathic intracranial hypertension: a multi-institutional and multinational database study
• Sinonasal neuroendocrine carcinoma in a previously healthy young adult male
• Candidate Key Proteins of Tinnitus in the Auditory and Motor Systems of the Thalamus
• Unilateral Hearing Loss as the Sole Presentation of Extensive Intracranial Epidermoid Cyst: A Case Report
• Exploring How Blood Cell Levels Influence Subjective Tinnitus: A Cross-Sectional Case-Control Study
• A Cure for Tinnitus After Tinnitus Retraining Therapy: Insights From a Large Case Series

Before initiating treatment, rule out reversible or treatable causes:

• Hearing loss (age-related or noise-induced)
• Earwax impaction
• Ototoxic medications (NSAIDs, aminoglycosides, chemotherapy)
• Temporomandibular joint (TMJ) dysfunction
• Vascular anomalies (especially in pulsatile tinnitus)
• Vestibular schwannoma (consider in unilateral tinnitus)

Uses external sounds to reduce tinnitus perception.

• White noise machines
• Hearing aids with built-in masking features
• Custom tinnitus maskers
• Sound pillows or mobile apps

Psychological approach with strong evidence of benefit.

• Reduces distress, improves coping
• Typically delivered in structured sessions

For patients with coexisting hearing loss.

• Amplifies environmental sounds
• May reduce tinnitus awareness

Combines low-level sound stimulation with counseling.

• Goal: habituation to tinnitus
• Long-term process (6–24 months)

Tinnitus medical treatment

• Repetitive transcranial magnetic stimulation (rTMS)
• Bimodal neuromodulation (e.g., Lenire® system)
• Supplements (e.g., Ginkgo biloba, melatonin) — low evidence

• Avoid complete silence — use background sounds
• Limit caffeine, nicotine, and alcohol
• Practice stress-reduction techniques (e.g., mindfulness, yoga)
• Improve sleep hygiene

Refer to ENT or neurology if:

• Unilateral tinnitus
• Pulsatile tinnitus
• Neurological symptoms
• Severe impact on quality of life despite initial management

Deep brain stimulation for tinnitus